As opioid overdoses rise, colleges supply reversal drug

Colleges are increasingly stocking up on an easy-to-use opioid overdose antidote as the number of incidents keeps rising with young adults among those most at risk.

Opioids killed nearly 4,000 Americans ages 15 to 24 in 2016, nearly a third more than the year before. And while over 30 percent of college students said they knew someone who had overdosed on pain pills or heroin, even more — over 37 percent — reported not knowing what to do if they were present, a survey by the Hazelden Betty Ford Institute for Recovery Advocacy and The Christie Foundation found.

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Perhaps the best thing they could do in the moment would be to spray Narcan up a buddy’s nostril — assuming it’s available.

To save lives and teach students about drug risks, many education and advocacy groups have been pushing campuses to supply the emergency opioid overdose reversal medication. Injectable forms of the generic naloxone have been used by paramedics and emergency physicians for decades, and spread to college health clinics and campus police a few years ago.

Narcan, the made-for-consumers nasal spray brand, hit the market in early 2016, dramatically expanding where the medication could be placed and who could use it.

The drug does not address the root causes of the opioid epidemic. But as more Americans overdose on prescription painkillers and illicit heroin and fentanyl, it offers an alternative to waiting for emergency workers.

Advocates argue that even the few minutes it takes for police to arrive at the scene of an overdose could be too long to prevent brain damage or even death as the body’s breathing reflex shuts down. So, there is a growing movement in higher education to get Narcan in the hands of resident assistants or campus security guards — or to make it directly available around campuses in the same way portable defibrillators and first-aid kits are.

“For all channels of naloxone distribution, the guiding principle should be to put the drug in the hands of actual opioid users or people most likely to be around during an overdose,” Scott Burris, director of the Center for Public Health Law Research at Temple University, said. “Doses in cops’ trunks or university cupboards won’t help. I suspect the main issue at colleges will be how effective the outreach is to students using opioids.”

Bridgewater State University in Massachusetts has made Narcan publicly available in about 50 defibrillator cases in nearly every building on campus, and trained hundreds of students, faculty and staff in how to use it. The Police Assisted Addiction and Recovery Initiative paid for the initial doses. The university will foot the bill in the future.

No agency tracks how many times it has been used or how many lives have been saved. But there are personal accounts.

“I know of three incidents that we have gotten reports of that naloxone and Narcan have been used on students,” said Mark Kinzly, co-founder of the Texas Overdose Naloxone Initiative. “All three of the ones we got feedback on were off-campus housing.”

The initiative, in collaboration with the University of Texas at Austin’s Operation Naloxone, has given the medication to Texas colleges and trained students and staff how to evaluate and respond to possible overdoses.

While Narcan is designed to be used by people without medical backgrounds, they still should be trained in recognizing an overdose and on what to do after it is administered, said Lucas Hill, a clinical assistant professor at UT-Austin’s College of Pharmacy and director of Operation Naloxone.

Because naloxone blocks opioid receptors in the brain, its most serious side effect is beginning the painful process of withdrawal. It has no effect on someone whose symptoms are not due to opioid overdosing.

In pharmacies, where naloxone can be purchased without a prescription in most states, the Narcan nasal spray typically retails for $110 to $150 for a box with two doses (insurance coverage varies). Colleges often get funding through the 21 st Century Cures Act and advocacy groups, with many doses also supplied by pharmaceutical companies.

Adapt Pharma, the Dublin-based maker of Narcan, and the Clinton Health Matters Initiative pledged last April to donate up to 40,000 doses to U.S. universities. While that’s far from enough to supply all residential areas — the program allows Title IV-eligible, degree-granting colleges and universities to apply for up to four boxes apiece — it’s a widely publicized start.

Connecticut State Colleges and Universities announced in September that campus police and other trained staff at all campuses would be equipped with the reversal drug.

“It is our sincere hope that the staff at CSCU colleges and universities never have to resort to the use of Narcan on their campuses,” said CSCU President Mark Ojakian in a statement. “Recent history, however, suggests it is significantly better to be prepared for these cases if and when they occur.”

The University of Wisconsin System recently announced that it, too, would provide nine of its campuses with free Narcan, beginning with law enforcement and security officers and eventually residential assistants in dorms.

“Most colleges should do a lot better with having naloxone access on campus and making sure that appropriate individuals are trained to know what to do if they see someone who has overdosed,” said Tim Rabolt, director of community relations and strategic advancement at the Association of Recovery in Higher Education.